I am a physician with long-standing interests in health policy, medical ethics and free-market economics. I am the co-founder of Freedom and Individual Rights in Medicine (FIRM). I graduated from University of Michigan Medical School and completed my residency in diagnostic radiology at the Washington University School of Medicine in St. Louis (where I was also a faculty member). I'm now in private practice in the Denver area. All my opinions are my own, and not necessarily shared by my employer.

The Battle Of The Narrative: How Ordinary Americans Can Fight ObamaCare

A woman demonstrates against US President Barack Obama's health care reforms in front of the US Supreme Court in Washington, DC . (Image credit: AFP via @daylife)

The 2012 election ensured that ObamaCare will not be repealed anytime soon. But opponents continue to fight back. 26 state governments have declined to establish insurance “exchanges.” 40 lawsuits are still pending against various aspects of ObamaCare. Ordinary Americans may not be able to directly affect these battles. But they can play a key role in the all-important battle of the “narrative.”

As the problems of ObamaCare inevitably emerge, the big question will be whether they will be blamed on the residual free-market elements of our health system or on the new government controls. This will be the battle of the “narrative.”

ObamaCare has already caused economic harm. For example, employers with more than 50 full-time workers must provide government-approved health plans or else pay a stiff penalty. As a result, many small and large employers have announced layoffs and/or work-hour reductions to avoid these increased business costs.

Many on the Left are blaming greedy employers for heartlessly refusing to provide employees’ health insurance. But in fact, these businesses typically operate on thin margins. These staffing changes are necessary for them to remain economically viable. The problem is not employer greed, but rather government mandates on employers.

ObamaCare has also spawned a lobbying frenzy by special interest groups seeking to have their pet benefits included in the state-level “essential health benefits” that all insurers must sell (and that consumers subject to the individual mandate must purchase).

Four states — California, Maryland, New Mexico and Washington included acupuncture for treating pain, nausea and other ailments… [I]nsurance plans will have to cover weight-loss surgery in New York and California, for example, but not in Minnesota or Connecticut. Infertility treatment will be a required benefit in New Hampshire, but not in Arizona.

If lobbyists can persuade legislators to compel coverage of their favored medical services, it’s like hitting the regulatory jackpot. Consumers will be forced to purchase services they may neither need nor want, because of the political pull of special interest groups. Again, the problem is not the free market, but rather government controls over the market.

(A similar lobbyist feeding frenzy occurred after Massachusetts passed its mandatory insurance law in 2006. Cato health policy analyst Michael Cannon noted that special interests successfully lobbied to require several new benefits, including drug-abuse treatment, early intervention for autism, hospice care, hormone replacement therapy, and non-in-vitro fertility services. These new mandates were part of the reason that insurance costs in Massachusetts rose by nearly double the national average after 2006.)

Under ObamaCare, insurance rates will also skyrocket for young people. New government rules mandate that insurers can charge older Americans at most 3 times what they charge younger customers, even when older people require many more medical services than the young. To stay viable, insurers must artificially raise the rates on the younger patients, essentially forcing the young to subsidize seniors’ insurance costs. Again, the blame for these insurance “rate shocks” should fall on the government, not the private sector.

More generally, we should not let the government escape responsibility for problems they’ve created. This will becoming increasingly important as more ObamaCare problems emerge, such as patients being denied treatments by government-spawned “Accountable Care Organizations” (ACOs) or by government bureaucracies such as the Independent Payment Advisory Board (IPAB) and the US Preventive Services Task Force (USPSTF).

If we let the government shift responsibility for ObamaCare’s problems onto the residual private sector, those problems will eventually be used to justify a government-run “single payer” system. On the other hand, if Americans hold the government appropriately responsible, we stand a chance at adopting genuine free-market health reforms.

The government is already planning its own health care propaganda campaign aimed at the American people. California state government officials in charge of implementing that state’s ObamaCare “exchange” want Hollywood to include pro-ObamaCare storylines in popular shows like “Grey’s Anatomy” and “Modern Family” to highlight the supposed benefits of the new law.

Ordinary Americans can fight back by speaking out against the government narrative when appropriate with family and friends. Of course, this doesn’t mean starting unnecessary fights over politics. As humorist Dave Barry once quipped, “I can win an argument on any topic, against any opponent. People know this, and steer clear of me at parties. Often, as a sign of their great respect, they don’t even invite me.” You don’t want to be the annoying blowhard ruining the family Christmas dinner.

Nor is it always necessary to persuade ObamaCare supporters to change their minds (although it’s nice when that happens). It’s far more important to simply show that there is thoughtful mainstream opposition to the law. Fortunately, most Americans still dislike ObamaCare and don’t believe it’s the federal government’s job to ensure that all citizens have health care coverage. Our job is to let them know why they’re right.

The writer Ayn Rand once said, “You can never tell when your words will reach the right mind at the right time. You will see no immediate results — but it is of such activities that public opinion is made.”

The electoral battle of 2012 is over, but the battle of the narrative is just beginning. Whichever side wins that battle will determine the future of American health care.

Paul Hsieh, MD, is a physician and co-founder of Freedom and Individual Rights in Medicine (FIRM). He practices in the Denver area.

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